2017-05-03T10:00:43-07:00 2016-06-30 990 2015-07-01 250461835 ELLWOOD CITY HOSPITAL ELLW 7247526819 724 PERSHING STREET ELLWOOD CITY PA 16117 Christopher Little Vice President, CFO 7247526749 2017-05-03 2015 2021-01-29 14:40:06Z CHRISTOPHER M LITTLE 724 PERSHING STREET ELLWOOD CITY PA 16117 30238590 0 X WWW.THEELLWOODCITYHOSPITAL.ORG X 1913 PA THE ELLWOOD CITY HOSPITAL IS AN ACUTE CARE GENERAL HOSPITAL CONSISTING OF 52 ACUTE CARE AND SWING BEDS AND 10 BEHAVIORAL HEALTH BEDS. THE HOSPITAL PROVIDES INPATIENT, OUTPATIENT, HOME HEALTH CARE AND EMERGENCY ROOM SERVICES TO THE TRI-COUNTY AREA OF LAWRENCE, BUTLER, AND BEAVER COUNTIES. THE OBJECTIVES OF THIS CORPORATION SHALL BE TO MAINTAIN, SUPPORT, AND MANAGE, WITHIN A 100 MILE RADIUS OF THE BORO OF ELLWOOD CITY, PA, A GENERAL HOSPITAL, HOME HEALTH SERVICES, PHARMACY SERVICES, PHYSICAL THERAPY SERVICES AND WELLNESS SERVICES, FOR DIAGNOSTIC AND TREATMENT SERVICES TO ALL PATIENTS THROUGHOUT THE RANGE FROM PREVENTIVE SERVICES THROUGH REHABILITATION WITHOUT REGARD TO RACE, ANCESTRY, RELIGION, OR ABILITY TO PAY. 15 14 440 66 0 0 3469068 4546780 25204509 24449190 40750 34581 955870 1030789 29670197 30061340 0 0 0 0 17532379 17783333 0 0 0 11086150 11785677 28618529 29569010 1051668 492330 49555251 43909862 19124280 21377091 30430971 22532771 THE OBJECTIVES OF THIS CORPORATION SHALL BE TO MAINTAIN, SUPPORT, AND MANAGE, WITHIN A 100-MILE RADIUS OF THE BOROUGH OF ELLWOOD CITY, PA, A GENERAL HOSPITAL, EMERGENCY SERVICES, HOME HEALTH SERVICES, PHARMACY SERVICES, PHYSICAL THERAPY SERVICES AND WELLNESS SERVICES, FOR DIAGNOSTIC AND TREATMENT SERVICES TO ALL PATIENTS THROUGHOUT THE RANGE FROM PREVENTIVE SERVICES THROUGH REHABILITATION WITHOUT REGARD TO RACE, ANCESTRY, RELIGION OR ABILITY TO PAY. 0 0 21052082 0 24449190 FROM JULY 1, 2015 TO JUNE 30, 2016, THE HOSPITAL PROVIDED INPATIENT SERVICES TO 1,618 PATIENTS ACCUMULATING 10,188 DAYS OF PATIENT CARE. IN ADDITION TO INPATIENT AND SWING BED CARE, THE HOSPITAL PROVIDES 24-HOUR EMERGENCY ROOM SERVICES. DURING THE FISCAL YEAR, THE HOSPITAL HAD EMERGENCY VISITS OF 12,163. THE ELLWOOD CITY HOSPITAL HOME HEALTH AGENCY PROGRAM HAD VISITS OF 20,690. DURING THE FISCAL YEAR, SERVICES ARE PROVIDED TO ALL PATIENTS WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, RELIGIOUS CREED, OR HANDICAP. THE HOSPITAL MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE IT PROVIDES. THESE RECORDS INCLUDE THE AMOUNT OF CHARGES FOR-GONE FOR SERVICES AND SUPPLIES FURNISHED UNDER ITS CHARITY CARE POLICY. DURING THE FISCAL YEAR, THE HOSPITAL PROVIDED UNCOMPENSATED AND CHARITY CARE IN THE AMOUNT OF $32,922,126. IN ADDITION TO CHARITY AND UNCOMPENSATED CARE, SERVICES ARE PROVIDED UNDER THE MEDICAID PROGRAM TO FINANCIALLY NEEDY PATIENTS. THE HOSPITAL ALSO CO-SPONSORS THE ELLWOOD CITY MEALS ON WHEELS PROGRAM BY PROVIDING THE PREPARATION OF FOODS FOR ALL MEALS SERVED. THE ELLWOOD CITY HOSPITAL AND THE ELLWOOD CITY HOSPITAL AUXILIARY ALSO PROVIDE A TECH ALERT SYSTEM FOR THE ELDERLY, YEARLY (AS WELL AS THROUGHOUT THE YEAR) INFORMATIONAL FAIRS, SUCH AS PRENATAL CLASSES, SIBLING CLASSES, BABYSITTING CLASSES, NATIONAL SAFETY BELT/SAFETY WEEK, BREAST CANCER AWARENESS WEEK, PROSTATE SCREENINGS, AND GENERAL HEALTH SCREENINGS TO NAME A FEW. THE HOSPITAL AND AUXILIARY ALSO PARTICIPATE WITH VARIOUS LOCAL, CIVIC, AND SCHOOL GROUPS TO PROVIDE OUTREACH SERVICES TO THE TRI-COUNTY AREA. SUCH PROGRAMS INCLUDE KINDERGARTEN TOURS OF THE HOSPITAL, A VOLUNTEER PROGRAM, AND USE OF THE HOSPITAL AS A CLINICAL SITE FOR AREA NURSING STUDENTS. THE HOSPITAL ALSO ENCOURAGES ITS EMPLOYEES TO BECOME INVOLVED WITH VOLUNTEER SERVICES SUCH AS THE UNITED WAY, THE RED CROSS ANNUAL BLOOD DRIVE, AND VARIOUS COMMUNITY PROJECTS. THE ELLWOOD CITY HOSPITAL, IN COOPERATION WITH HIGHMARK BLUE CROSS BLUE SHIELD, OFFERS A LOW COST COVERAGE PROGRAM CALLED SPECIAL CARE AND THE CARING PROGRAM. SPECIAL CARE IS DESIGNED FOR INDIVIDUALS AND FAMILIES WITH LOW INCOMES WHO ARE INELIGIBLE FOR GOVERNMENT ASSISTANCE AND THE CARING PROGRAM IS FOR CHILDREN OF LOW INCOME FAMILIES. 0 0 0 21052082 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 1 0 1 1 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 108 0 440 1 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 PA X CHRISTOPHER M LITTLE 7247526819 724 PERSHING STREET ELLWOOD CITY PA 16117 CAROLYN IZZO PRESIDENT/CEO 56 4 X X 222452 0 12052 CHRISTY SPOA CHAIRMAN 2 1 X X 0 0 0 FRANK MARTZ 1ST VICE CHAIRMAN 2 1 X X 0 0 0 DAVID BARENSFELD 2ND VICE CHAIRMAN 2 0.5 X X 0 0 0 JOHN WHITE SECRETARY 2 1 X X 0 0 0 GUS FORNATARO TREASURER 2 0.5 X X 0 0 0 CLYDE BARTLEY MEMBER 2 0.5 X 0 0 0 GERALD CROWLEY MEMBER 2 1 X 0 0 0 GREGORY FOX MEMBER 2 0.5 X 0 0 0 MARY ANN DIBIAGIO MEMBER 2 0.5 X 0 0 0 PETRA NOUR MEMBER 2 0.5 X 0 0 0 MARK SCHNURER MEMBER 2 0.5 X 0 0 0 ARTHUR SMILEK MEMBER 2 1 X 0 0 0 MARK TOMASZEWSKI MEMBER 2 0.5 X 0 0 0 LINDA RAYMUNDO MEMBER 2 0.5 X 0 0 0 CHRISTOPHER M LITTLE CFO 44 6 X 210018 0 16028 KRISTI B GARMA DIRECTOR OF REHAB SVCS/BUSINESS DEVELOPMNT 25 25 X 104520 0 3084 536990 0 31164 3 0 1 0 ALLEGHENY HEALTH NETWORK EMERGENCY GROUP 4535 DRESSLER ROAD NW CANTON OH 44718 EMERGENCY ROOM PHYSICIAN SERVICES 712394 HORIZON HEALTH PO BOX 840839 DALLAS TX 75284 BEHAVIORAL HEALTH MANAGEMENT SERVICES 680411 PHARMACY SYSTEMS INC PO BOX 71-0716 COLUMBUS OH 43271 MEDICAL SERVICES 537433 DIVERSIFIED CLINICAL SERVICES PO BOX 636981 CINCINNATI OH 45263 WOUND CARE SERVICES 289503 LABCORP OF AMERICA 231 MAPLE AVE BURLINGTON NC 27216 LABORATORY TESTING 162857 8 0 1340 17974 4500000 18008 9458 0 4546780 MEDICAL SERVICES 900099 24449190 24449190 0 0 0 0 0 0 24449190 30081 0 0 30081 0 0 0 0 0 0 0 0 172992 0 133249 0 39743 0 39743 0 0 39743 0 4500 0 0 0 4500 4500 0 0 4500 26171 17974 13040 13131 0 13131 56088 30961 25127 0 0 25127 MEALS ON WHEELS/CAFETERIA 900099 196914 0 0 196914 MISCELLANEOUS 900099 755874 0 0 755874 0 0 0 0 952788 30061340 24449190 0 1065370 0 0 0 0 0 0 0 0 432470 0 432470 0 0 0 0 0 13982276 11195309 2786967 0 544487 505384 39103 0 1765626 1377188 388438 0 1058474 834761 223713 0 0 0 0 0 102631 0 102631 0 194411 0 194411 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 28544 1116 27428 0 3478760 2929962 548798 0 0 0 0 0 0 0 0 0 792830 2576 790254 0 106488 66019 40469 0 0 0 0 0 3166 128 3038 0 165630 12001 153629 0 0 0 0 0 1294853 0 1294853 0 536915 0 536915 0 REPAIRS & MAINTENANCE 714137 599526 114611 0 CONTRACTED SERVICE HOSPITAL FEES 3938123 3152070 786053 0 BLOOD BANK / OUTSIDE TESTING 356156 356156 0 0 LOAN FEES 6643 0 6643 0 66390 19886 46504 0 29569010 21052082 8516928 0 9034 603611 0 0 0 0 2915857 2521009 202839 75237 0 0 0 0 606864 563903 2946567 2721084 45628874 37972866 8789806 7656008 359446 351136 0 0 0 0 0 0 33724838 29417874 49555251 43909862 3787720 4299306 0 0 0 0 0 0 0 0 0 0 5170772 4657805 0 0 10165788 12419980 19124280 21377091 X 29157212 21284668 12658 13156 1261101 1234947 30430971 22532771 49555251 43909862 X 492330 0 0 0 0 -8390530 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 5425 5425 0 Schedule C, Part II-B, Line 1 THE ELLWOOD CITY HOSPITAL HOLDS MEMBERSHIP IN THE HOSPITAL & HEALTH SYSTEM ASSOCIATION OF PENNSYLVANIA (HAP) AND THE HOSPITAL COUNCIL OF WESTERN PENNSYLVANIA (HCWP) WHICH ENGAGE IN LOBBYING AS PART OF THEIR MISSION TO REPRESENT THE INTEREST OF HOSPITALS AT BOTH THE FEDERAL AND STATE LEVELS. 359446 0 -4675 0 0 3635 351136 361231 0 1998 0 0 3783 359446 28861522 0 39151 0 28539435 7 361231 27270504 0 2911763 0 307993 1012752 28861522 27356058 0 640046 0 713625 11975 27270504 0 1 0 0 1 1 0 54546 54546 0 12054043 8851328 3202715 0 0 0 0 0 32521993 28706254 3815739 0 998292 415284 583008 7656008 INTEREST IN FOUNDATION ASSETS 28508883 DUE FROM SUBSIDIARIES AND FOUNDATION 239555 MALPRACTICE INSURANCE RECOVERY 227600 INVESTMENT IN ELLWOOD CITY HEALTH ORG, INC. 190215 INVESTMENT IN CHART 71000 INVESTMENT IN VANTAGE 180621 29417874 0 MINIMUM PENSION LIABILITY 11866912 MALPRACTICE INSURANCE CLAIMS 227600 TOSHIBA CAPITAL LEASE 251096 OLYMPUS CAPITAL LEASE 74372 12419980 X 30185932 0 0 0 0 0 30185932 0 -124592 -124592 30061340 29694100 0 0 0 0 0 29694100 0 -125090 -125090 29569010 Schedule D, Part V, Line 4 THE ENDOWMENT ASSETS ARE TO BE INVESTED SO THAT LONG-RANGE GOALS OF THE ORGANIZATION ARE MET. THE ORGANIZATION BELIEVES IT IS IMPORTANT TO PRESERVE CAPITAL AND ITS PURCHASING POWER. FURTHER, THE ENDOWMENT ASSETS' PRINCIPAL SHOULD INCREASE IN VALUE TO PROVIDE THE NECESSARY BASE FOR THE GENERATION OF INCOME FOR CURRENT AND FUTURE ORGANIZATION NEEDS. Schedule D, Part X, Line 2 THE ORGANIZATION HAS ADOPTED THE STANDARD FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES BY PRESCRIBING THE RECOGNITION THRESHOLD A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. IT ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE, AND TRANSITION. Schedule D, Part XI, Line 4b RENTAL EXPENSES ASSOCIATED WITH PHYSICIAN RENT ALREADY DEDUCTED FROM RENTAL INCOME. Schedule D, Part XII, Line 4b RENTAL EXPENSES ASSOCIATED WITH PHYSICIAN RENT ALREADY DEDUCTED FROM RENTAL INCOME. GOLF OUTING 22042 17974 4068 32 760 2750 1318 0 869 0 0 22042 17974 4068 32 760 2750 1318 0 869 5729 -1661 1 1 1 X 3 1 X 1 1 0 0 0 0 67063 0 67063 0.0023 0 0 2659502 1231576 1427926 0.0483 0 0 39898 15784 24114 0.0008 0 0 2766463 1247360 1519103 0.0514 6 0 426659 70656 356003 0.012 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 6 0 426659 70656 356003 0.0120 6 0 3193122 1318016 1875106 0.0634 0 600307 0 5009824 5009824 0 X 1 1 1 1 ELLWOOD CITY HOSPITAL 724 PERSHING STREET ELLWOOD CITY PA 16117 http://www.theellwoodcityhospital.org X X X ELLWOOD CITY HOSPITAL 1 0 0 1 X X X X X X X X X 15 1 0 0 1 X http://www.theellwoodcityhospital.org X 1 15 1 https://www.theellwoodcityhospital.org 0 0 1 X 300 350 X X X 1 1 X X X X 1 X http://www.theellwoodcityhospital.org X http://www.theellwoodcityhospital.org X X X X 1 X 0 X X X 1 X X 0 0 Schedule H, Part V, Section B, Line 5-ELLWOOD CITY HOSPITAL THE PRIMARY INTERVIEW DATA INCLUDED OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL AND INCLUDED THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES. ARNETT, CARBIS, TOOTHMAN, AN INDEPENDENT ACCOUNTING FIRM, WORKED TOGETHER WITH THE ELLWOOD CITY HOSPITAL COMMUNITY HEALTH NEEDS ASSESSMENT STEERING COMMITTEE TO DEVELOP A BROAD LIST OF COMMUNITY LEADERS TO INTERVIEW. THESE COMMUNITY MEMBERS WERE SELECTED BASED ON THEIR INVOLVEMENT WITHIN THE COMMUNITY AND BECAUSE THEY PROVIDED DISTINCTIVE BACKGROUNDS AND A VARIETY OF PERSPECTIVES ON THE STATE OF THE COMMUNITY AND HEALTH CARE. INTERVIEWS WERE CONDUCTED WITH A NUMBER OF DIRECTORS AND STAFF MEMBERS FROM COMMUNITY HEALTH CENTERS, MEMBERS FROM SOCIAL SERVICES ORGANIZATIONS, EDUCATIONAL LEADERS, RELIGIOUS GROUPS, AND ELECTED OFFICIALS. THE SELECTED PARTICIPANTS GIVE AN OVERARCHING VIEWPOINT OF THE COMMUNITY AND THROUGH THESE INTERVIEWS THE HEALTH NEEDS FROM THE PERSPECTIVE OF THE COMMUNITY WERE IDENTIFIED. Schedule H, Part V, Section B, Line 11-ELLWOOD CITY HOSPITAL THE ELLWOOD CITY HOSPITAL IS ADDRESSING THE SIGNIFICANT NEEDS IDENTIFIED IN ITS MOST RECENTLY CONDUCTED CHNA BY THE ADOPTION AND EXECUTION OF AN IMPLEMENTATION STRATEGY THAT ADDRESSES EACH COMMUNITY HEALTH NEED. THE HOSPITAL PARTICIPATED IN THE DEVELOPMENT OF A COMMUNITY-WIDE PLAN AND IMPLEMENTED THE STRATEGY BY PRIORTIZING THE COMMUNITY HEALTH NEEDS AND THE SERVICES THAT THE HOSPITAL WILL UNDERTAKE TO MEET THE HEALTH NEEDS. IN ADDITION, A BUDGET WAS ADOPTED FOR THE SERVICES THAT WOULD BE PROVIDED BY THE HOSPITAL TO ADDRESS THE IDENTIFIED COMMUNITY HEALTH NEEDS. A NEED THAT IS NOT BEING ADDRESSED IS DRUG AND ALCOHOL ABUSE. THE HOSPITAL DOES NOT HAVE A DRUG AND ALCOHOL INPATIENT UNIT AND DOES NOT HAVE THE RESOURCES THAT WOULD BE REQUIRED TO EFFECT THE CHANGES THAT ARE NEEDED TO ADEQUATELY ADDRESS THE LACK OF DRUG AND ALCOHOL ABUSE CARE IN ITS SERVICE AREA. HOWEVER, THIS NEED IS BEING ADDRESSED BY NUMEROUS PROGRAMS AND INITIATIVES OPERATED BY OTHER COMMUNITY PARTNERS WITHIN LAWRENCE COUNTY AND SURROUNDING AREAS. THE HOSPITAL SUPPORTED BRINGING IN A NEW SUBOXONE DRUG ADDICTION TREATMENT CENTER TO THE COMMUNITY. THE HOSPITAL WILL CONTINUE TO EVALUATE AND INTENDS TO ADDRESS IN A FUTURE PLAN. Schedule H, Part V, Section B, Line 22d-ELLWOOD CITY HOSPITAL THE MAXIMUM AMOUNTS CHARGED TO FAP-ELIGIBLE INDIVIDUALS ARE THE SAME AMOUNTS BILLED TO INDIVIDUALS WHO HAVE INSURANCE. FAP-ELIGIBLE INDIVIDUALS ARE DETERMINED TO BE ELIGIBLE FOR FREE OR DISCOUNTED CARE BASED ON FEDERAL POVERTY GUIDELINES. SELF-PAY INDIVIDUALS ARE OFFERED 50% SELF-PAY DISCOUNTS OFF BILLED AMOUNTS AND 15% PROMPT PAY DISCOUNTS. 3 ELLWOOD CITY HOSPITAL BEHAVIORAL HEALTH UNIT 724 PERSHING STREET ELLWOOD CITY PA 16117 AN INPATIENT GERIATRIC BEHAVIORAL HEALTH UNIT THAT OPERATES AS A COST CENTER WITHIN HOSPITAL. ELLWOOD CITY HOSPITAL HOME HEALTH AGENCY 402 BEATTY STREET ELLWOOD CITY PA 16117 A HOME HEALTH AGENCY THAT OPERATES AS A COST CENTER WITHIN THE HOSPITAL. ZELIENOPLE DIAGNOSTIC CENTER 241 NORTH PERRY HIGHWAY UNIT 1 HARMONY PA 16037 AN OUTPATIENT DIAGNOSTIC CENTER THAT OPERATES AS A COST CENTER WITHIN THE HOSPITAL. Schedule H, Part I, Line 7 THE AMOUNTS DERIVED FOR CHARITY CARE AND CERTAIN OTHER COMMUNITY BENEFITS AT COST WERE CALCULATED USING THE HOSPITAL'S OWN INTERNAL REPORTING SYSTEM IN ACCESSING TOTAL CHARGES FOR EACH CATEGORY WHERE APPLICABLE. THE SYSTEM ADDRESSES ALL PATIENT SEGMENTS. COSTS FOR EACH OF THE AREAS WERE DERIVED USING WORKSHEET 2 FROM SCHEDULE H INSTRUCTIONS, "RATIO OF PATIENT CARE COST-TO-CHARGES". Schedule H, Part III, Section A, Line 4 THE BAD DEBT EXPENSE AT COST WAS DETERMINED BASED ON THE HOSPITAL'S REPORTED BAD DEBT EXPENSE AT GROSS AND MULTIPLIED BY THE "RATIO OF PATIENT CARE COST-TO-CHARGES" FROM WORKSHEET 2 FROM SCHEDULE H INSTRUCTIONS. THE HOSPITAL'S FINANCIAL STATEMENTS STATE THAT MANAGEMENT ALSO PROVIDED FOR BAD DEBTS, WHICH PRIMARILY RELATE TO PATIENT RECEIVABLES FROM INDIVIDUALS, WHICH IT DETERMINES ARE UNCOLLECTABLE. SUCH BAD DEBTS AMOUNTED TO $1,102,000 IN 2016. THE HOSPITAL'S FINANCIAL STATEMENTS DO NOT INCLUDE A FOOTNOTE THAT FURTHER DESCRIBES BAD DEBT EXPENSE. BAD DEBT EXPENSE IS ACCOUNTED FOR BY ESTIMATING ON A MONTHLY BASIS THE AMOUNT OF BAD DEBT EXPENSE BASED ON HISTORICAL REIMBURSEMENT FOR OUTSTANDING ACCOUNTS RECEIVABLE BALANCES BY PAYOR AND TAKING INTO ACCOUNT THE AGING OF SUCH RECEIVABLES ALONG WITH ACTUAL ACCOUNTS WRITTEN OFF. Schedule H, Part III, Section B, Line 8 MEDICARE ALLOWABLE COSTS OF CARE WERE DERIVED FROM THE MEDICARE COST REPORT WITH REIMBURSEMENT BASED ON THE PROSPECTIVE PAYMENT SYSTEM. OVERHEAD COSTS WERE ALLOCATED BASED ON STATISTICAL ALLOCATIONS TO THE HOSPITAL'S ANCILLARY DEPARTMENTS AFTER DEPARTMENTAL RECLASSES AND ADJUSTMENTS. Schedule H, Part III, Section C, Line 9b THE HOSPITAL'S COLLECTION POLICY DOES CONTAIN PROVISIONS ON THE COLLECTIONS PRACTICES TO BE FOLLOWED FOR PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE OR FINANCIAL ASSISTANCE. PATIENTS WHO ARE KNOWN TO QUALIFY FOR CHARITY CARE WILL REMAIN A QUALIFYING PATIENT FOR SIX MONTHS FOLLOWING INITIAL QUALIFICATION. THESE PATIENTS ARE TRACKED AND EVALUATED ON ANY SUBSEQUENT STAYS THAT MAY OR MAY NOT OCCUR IN THE FOLLOWING SIX MONTHS. THE COLLECTION POLICY ALSO COVERS THOSE PATIENTS WHO ARE UNINSURED AND THE PROCESS IN WHICH THEY CAN RECEIVE FINANCIAL ASSISTANCE IN THE FORM OF DISCOUNTS AND/OR PAYMENT ARRANGEMENTS. IF ACCOUNTS ARE NOT PAID IN FULL OR PAYMENT ARRANGEMENTS ARE NOT FOLLOWED, THEN FOLLOW-UP LETTERS ARE INITIATED AS A FRIENDLY REMINDER. IF THE ACCOUNT BECOMES DELINQUENT, THE ACCOUNT IS CONSIDERED FOR REFERRAL TO BAD DEBT. Schedule H, Part VI, Line 2 THE ORGANIZATION ASSESSED THE HEALTH CARE NEEDS FOR THE COMMUNITIES IT SERVES BY PERFORMING A COMPREHENSIVE PROCESS THAT INCLUDED A COMBINATION OF COMMUNITY FEEDBACK, HOSPITAL STAFF REPRESENTATION, CONTRIBUTING SOCIAL AGENCY LEADERS AND GOVERNMENTAL OFFICIALS, AND SELECTED PRIMARY AND SECONDARY SOURCES OF DATA TO DISTINGUISH AREAS FOR IMPROVEMENT. THE PRIMARY INTERVIEW DATA INCLUDED OPINIONS FROM PERSONS WHO REPRESENT THE BROAD INTERESTS OF THE COMMUNITY SERVED BY THE HOSPITAL AND INCLUDED THOSE WITH SPECIAL KNOWLEDGE AND EXPERTISE OF PUBLIC HEALTH ISSUES. CONVENTIONAL HEALTH GUIDES AS WELL AS DEMOGRAPHIC, ECONOMIC, SOCIAL, AND ENVIRONMENTAL FACTORS WERE EVALUATED. THE DATA WAS UTILIZED TO ADDRESS THE IDENTIFIED HEALTH NEEDS OF THE SERVICE AREA, TO HELP SET PRIORITIES, AND TO PROVIDE RECOMMENDATIONS TO THE HOSPITAL ON WAYS TO MEET THE COMMUNITY HEALTH NEEDS. Schedule H, Part VI, Line 3 THROUGH THE COMBINATION OF THE HOSPITAL'S PATIENT CREDIT AND COLLECTION POLICY AND THE COMMUNITY CARE GUIDELINES POLICY, GUARANTORS ARE INFORMED AND EDUCATED ABOUT THEIR AVAILABILITY FOR ASSISTANCE PROGRAMS OR CHARITY CARE. THERE ARE PHYSICAL POSTINGS IN THE HOSPITAL FOR PATIENTS TO READ. ALSO WRITTEN ON PATIENT STATEMENTS ARE INSTRUCTIONS REGARDING HOW TO APPLY FOR ASSISTANCE OR CHARITY CARE. ALSO, THE HOSPITAL FINANCIAL ASSISTANCE FORMS ARE ON IT'S WEBSITE. THE UNINSURED ARE INFORMED OF THE AVAILABILITY OF A MEDICAL ASSISTANCE APPLICATION AND A CHARITY CARE APPLICATION IF THEY ARE NOT EXPECTED TO QUALIFY FOR MEDICAL ASSISTANCE. Schedule H, Part VI, Line 4 ELLWOOD CITY HOSPITAL IS LOCATED IN RURAL WESTERN PENNSYLVANIA SERVING PRIMARILY LAWRENCE, BUTLER, AND BEAVER COUNTIES. THE LOCAL COMMUNITY USED TO BE A THRIVING STEEL INDUSTRY AREA AND NOW CONSISTS OF AN AGING POPULATION. APPROXIMATELY 82% OF THE HOSPITAL'S PATIENTS ARE MEDICARE RECIPIENTS AND 5% ARE UNINSURED OR MEDICAID RECIPIENTS. Schedule H, Part VI, Line 5 THE HOSPITAL'S BOARD OF DIRECTORS IS COMPRISED OF BUSINESS PEOPLE WHO RESIDE IN THE PRIMARY SERVICE AREA WITH AN INTEREST IN THE CONTINUATION OF THE HOSPITAL IN PROVIDING MEDICAL SERVICES TO THE POPULATION. THE HOSPITAL EXTENDS MEDICAL STAFF PRIVILEGES TO ALL QUALIFIED PHYSICIANS IN THE COMMUNITY FOR ALL DEPARTMENTS. THE HOSPITAL IS ALSO PURSUING ARRANGEMENTS WITH OTHER HOSPITALS FOR ADDITIONAL PHYSICIAN STAFF TO PROVIDE HEALTH SERVICES. RESERVE CAPITAL FUNDS ALONG WITH CONTINUING OPERATIONS ARE BEING USED TO IMPROVE PATIENT CARE THROUGH THE PURCHASE OF UPDATED MEDICAL EQUIPMENT. FROM JULY 1, 2015 TO JUNE 30, 2016, THE HOSPITAL PROVIDED INPATIENT SERVICES (ACUTE CARE AND BEHAVIORAL HEALTH) TO 1,618 PATIENTS ACCUMULATING 10,188 DAYS OF PATIENT CARE. IN ADDITION TO INPATIENT CARE, THE HOSPITAL PROVIDED 24-HOUR EMERGENCY ROOM SERVICES DURING THE FISCAL YEAR. THE HOSPITAL HAD EMERGENCY VISITS OF 12,163. THE ELLWOOD CITY HOSPITAL HOME HEALTH AGENCY PROGRAM HAD VISITS OF 20,690 DURING THE FISCAL YEAR. SERVICES ARE PROVIDED TO ALL PATIENTS WITHOUT REGARD TO RACE, COLOR, NATIONAL ORIGIN, ANCESTRY, AGE, RELIGIOUS CREED, OR HANDICAP. SERVICES ARE PROVIDED UNDER THE MEDICAID PROGRAM TO FINANCIALLY NEEDY PATIENTS. THE HOSPITAL ALSO CO-SPONSORS THE ELLWOOD CITY MEALS ON WHEELS PROGRAM BY PROVIDING THE PREPARATION OF FOODS FOR ALL MEALS SERVED. THE ELLWOOD CITY HOSPITAL AND ELLWOOD CITY HOSPITAL AUXILIARY ALSO PROVIDE A TECH ALERT SYSTEM FOR THE ELDERLY, YEARLY (AS WELL AS THROUGHOUT THE YEAR) INFORMATIONAL FAIRS, SUCH AS NATIONAL SAFETY BELT/SAFETY WEEK, BREAST CANCER AWARENESS WEEK, PROSTATE SCREENINGS, AND GENERAL HEALTH SCREENINGS TO NAME A FEW. THE HOSPITAL AND AUXILIARY ALSO PARTICIPATE WITH VARIOUS LOCAL, CIVIC, AND SCHOOL GROUPS TO PROVIDE OUTREACH SERVICES TO THE TRI-COUNTY AREA. SUCH PROGRAMS INCLUDE KINDERGARTEN TOURS OF THE HOSPITAL, A VOLUNTEER PROGRAM, AND THE USE OF THE HOSPITAL AS A CLINICAL SITE FOR AREA NURSING STUDENTS. THE HOSPITAL ALSO ENCOURAGES ITS EMPLOYEES TO BECOME INVOLVED WITH VOLUNTEER SERVICES SUCH AS THE UNITED WAY, THE RED CROSS ANNUAL BLOOD DRIVE AND VARIOUS COMMUNITY PROJECTS. THE ELLWOOD CITY HOSPITAL, IN COOPERATION WITH HIGHMARK BLUE CROSS BLUE SHIELD, OFFERS A LOW COST COVERAGE PROGRAM CALLED SPECIAL CARE AND THE CARING PROGRAM. SPECIAL CARE IS DESIGNED FOR INDIVIDUALS AND FAMILIES WITH LOW INCOMES WHO ARE INELIGIBLE FOR GOVERNMENT ASSISTANCE AND THE CARING PROGRAM IS FOR CHILDREN OF LOW INCOME FAMILIES. Schedule H, Part VI, Line 6 THE HOSPITAL IS NOT PART OF AN AFFILIATED HEALTH CARE SYSTEM. Schedule H, Part VI, Line 7 THE HOSPITAL DOES NOT PREPARE A COMMUNITY BENEFIT REPORT. X X X X 0 0 0 0 0 0 0 0 0 CAROLYN IZZO PRESIDENT/CEO 222452 0 0 0 0 0 0 0 12052 0 234504 0 0 0 CHRISTOPHER M LITTLE CFO 210018 0 0 0 0 0 0 0 16028 0 226046 0 0 0 MARY ANN DIBIAGIO TRUSTEE PHYSICIAN PRACTICE STARTUP X 200000 75237 0 1 1 75237 Form 990, Part VI, Section A, Line 6 THE ELLWOOD CITY HOSPITAL FOUNDATION IS THE SOLE MEMBER OF THE HOSPITAL. Form 990, Part VI, Section A, Line 7a THE ELLWOOD CITY HOSPITAL FOUNDATION'S BYLAWS STATE THAT THE FOUNDATION AS SOLE MEMBER OF THE HOSPITAL SHALL ELECT ALL OF THE HOSPITAL BOARD MEMBERS. Form 990, Part VI, Section A, Line 7b THE HOSPITAL'S BOARD OF TRUSTEES WILL ALWAYS BE COMPRISED OF AT LEAST ONE MEMBER FROM THE ELLWOOD CITY HOSPITAL FOUNDATION'S BOARD OF TRUSTEES. AS A RESULT, THE HOSPITAL BOARD MAY NOT TAKE CERTAIN ACTIONS WITHOUT APPROVAL OF THE FOUNDATION SUCH AS: APPROVAL OF THE HOSPITAL'S BUDGET, MAKING STRATEGIC PLANNING DECISIONS, AUTHORIZING OR ENGAGING IN MARKETING OR COMMUNITY EDUCATION PROGRAMS, AND RESOURCE ALLOCATION. IN ADDITION, THE FOUNDATION WILL ENGAGE IN ALL FUNDRAISING ACTIVITIES ON BEHALF OF THE HOSPITAL AND HOLD, SUBJECT TO BOARD OR DONOR RESTRICTIONS, THE HOSPITAL'S INVESTMENT AND ENDOWMENT FUNDS AND MAKE INVESTMENT DECISIONS REGARDING THESE FUNDS. THEREFORE THE FOUNDATION WILL EXERCISE A SUBSTANTIAL DEGREE OF DIRECTION OVER THE POLICIES, PROGRAMS AND ACTIVITIES OF THE HOSPITAL. Form 990, Part VI, Section B, Line 11b THE ELLWOOD CITY HOSPITAL PREPARES ITS FORM 990 IN DRAFT FORM. IT IS REVIEWED BY MANAGEMENT OF THE ORGANIZATION FOR FINAL APPROVAL. MANAGEMENT THEN DISTRIBUTES THE COMPLETED FORM 990 AND ACCOMPANYING SCHEDULES TO ALL MEMBERS OF THE BOARD FOR REVIEW PRIOR TO FILING. Form 990, Part VI, Section B, Line 12c THE ELLWOOD CITY HOSPITAL ANNUALLY REQUIRES ITS BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES TO FILL OUT A CONFLICT OF INTEREST FORM DURING BOARD MEETINGS. IF AN INTERESTED PARTY HAS A CONFLICT, HE OR SHE RECUSES THEMSELVES FROM VOTING. Form 990, Part VI, Section B, Line 15 THE ELLWOOD CITY HOSPITAL'S BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF THEIR ORGANIZATION'S TOP MANAGEMENT. Form 990, Part VI, Section C, Line 19 AT THIS TIME, THE ELLWOOD CITY HOSPITAL DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC SINCE IT IS NOT REQUIRED TO DO SO UNDER CURRENT LAWS. Form 990, Part XI, Line 9 OTHER CHANGES IN NET ASSETS ARE COMPRISED OF LIABILITY FOR PENSION BENEFITS ($2,306,588), CHANGE IN NET UNREALIZED GAIN/LOSS ($19,822), CHANGE IN NET REALIZED GAIN/LOSS ($6,332), LOSS FROM SUBSIDIARY OPERATIONS ($1,638,013), AND CHANGE IN FOUNDATION VALUE ($4,419,775). ELLWOOD CITY HOSPITAL GIFT SHOP 724 PERSHING STREET ELLWOOD CITY PA 16117 251010071 GIFT SHOP AND FUNDRAISING PA 8657 13156 ELLWOOD CITY HOSPITAL ELLWOOD CITY HOSPITAL FOUNDATION 724 PERSHING STREET ELLWOOD CITY PA 16117 274160006 FOUNDATION PA 501 (c) (3) 11c N/A ELLWOOD CITY HEALTH ORGANIZATION INC 724 PERSHING STREET ELLWOOD CITY PA 16117 251801004 HEALTHCARE PA EC HOSPITAL C 0 0 1 1 APPLE OCCUPATIONAL HEALTH SERVICES INC 724 PERSHING STREET ELLWOOD CITY PA 16117 251801003 HEALTHCARE PA EC HLTH ORG INC C 0 0 0 0 OUTREACH CARE GROUP INC 724 PERSHING STREET ELLWOOD CITY PA 16117 251801005 HEALTHCARE PA EC HLTH ORG INC C 0 0 0 0 0 1 1 0 0 0 0 0 0 1 0 1 1 0 1 0 1 0 0 ELLWOOD CITY HEALTH ORGANIZATION INC b 1935222 USE OF INTERNAL ACCOUNTING RECORDS AND INVOICES FROM RELATED ENTITIES. ELLWOOD CITY HEALTH ORGANIZATION INC c 218086 USE OF INTERNAL ACCOUNTING RECORDS AND INVOICES FROM RELATED ENTITIES. AN EXTENSION OF TIME TO FILE AN EXEMPT ORGANIZATION RETURN HAS BEEN GRANTED TO MAY 15, 2017.